When a mass shooter struck Tucson, one item helped first responders save lives more than any other: police who responded all were equipped with Individual First Aid Kits (IFAKs) that included tourniquets and hemostatic agents.
Initially developed by the military to stabilize soldiers suffering from severe life-threatening injuries, blowout kits are designed only to allow a victim to survive long enough to be transported to a trauma facility or other area where advanced lifesaving tools and techniques are available. Blowout kits are primarily designed for the treatment of three types of traumatic injuries: penetrating chest wounds (leading to a pneumothorax or collapsed lung), severe bleeding (hemorrhage) or, in advanced kits, airway obstructions. As such, they normally include tools and treatments designed to provide immediate, but temporary, relief from such injuries.
Severe Blood Loss
Recent advancements in medicine have brought about the return of the tourniquet as a viable method to stem blood loss. Other developments introduced sponges that are impregnated with fast acting hemostatic agents.
Initial treatment to prevent blood loss is always direct pressure. Apply gauze and bandages to the wound and keep pressure on it until blood loss is stopped. In severe cases however, this may not always be effective.
The use of a hemostatic agent is the second step towards stemming blood loss. Most modern blowout kits have sponges or gauze that is treated with commercial agents such as Quick-Clot or Celox. The treatment is placed on the wound and pressure applied until blood loss stops. Keep the wrappers from any hemostatic agents with the victim so that professionals treating them later are aware of all previous treatments that have been used.
When presented with a severe limb injury resulting in massive blood loss, it is sometimes prudent to forgo the use of a blood-clotting agent and use a tourniquet to prevent the victim from bleeding out. Tourniquets are used to prevent blood flow to an extremity in order to staunch severe hemorrhaging of a limb. Modern tourniquet systems should include a tag or area where the first responder can note the time that the tourniquet was applied so that doctors and other medical professionals handling the patient at a trauma care center can be made aware.
Penetrating Chest Wounds
There are two issues that must be addressed in the case of a penetrating chest wound: the first is the possibility of a collapsed lung, and the other is the build up of air within the pleural cavity (tension pneumothorax) which can prevent the lung from inflating properly. Initial treatment usually calls for sealing the chest wound with a square of thin plastic. Some recommend sealing the wound completely to create an airtight barrier, but an alternative method intended to prevent air from building up within the pleural cavity is to seal three of the four sides with tape so that air is allowed to exit through the wound when the victim exhales, but is prevented from entering through the wound when the victim inhales.
Blowout kits intended for use by trained first responders usually include additional tools such as a nasopharyngeal airway (NPA) intended to deal with airway obstructions and a 3.25-inch 14-gauge needle to remove air that has built up inside the pleural cavity. The insertion of a needle into the second intercostal space in the midclavicular line to relieve a tension pneumothroax is an advanced technique and should ONLY be performed by a trained first responder or medical professional.
Before purchasing or assembling your own blowout or trauma kit, you should always seek out adequate training in the use of the equipment included in such a kit. Most states have “Good Samaritan” laws that protect those rendering first aid to a victim, but those laws do not go so far as to protect someone from being sued for malpractice when they are practicing advanced medical techniques, and some of the advanced tools of a blowout kit are better used in the hands of a trained medical professional.
Even if you have been trained in the past, it’s a good idea to seek out continuing education and refresher courses. Medical technology changes rapidly, and enrolling in a refresher course keeps you up to date on current modern practices.
You can assemble your own blowout kit customized to your own level of training and the needs you anticipate in your environment, as well as any health conditions that may impact you or your companions. Common supplements to these kits include Dermabond® (cyanoacrylate skin adhesive), glucose tablets, athsma inhaler, or an EpiPen®.
Even if you have extensive training with your first aid kit, put a book on basic first aid in your kit. You never know who may be using it in an emergency, and you may be the one who is hurt. Depending on the injury, you may be unconscious or unable to communicate, making it impossible for you to instruct someone helping you. Go over the use of your kit with your family and members of your household. If you are out hunting, let your hunting partner know where your emergency kit is and how to use it. After all, the whole purpose of having one is to be prepared when emergencies happen, and you never know when the person who needs to be saved will be yourself.
None of the information presented here should be construed in any way to be for medical advice. Cheaper Than Dirt! and our contributors cannot be held responsible for the use or misuse of any information presented here. You should seek out professional training and medical advice when putting together and learning how to use your first aid kit.